Orthopedic Care and Consultation
A laminotomy is a neurosurgical procedure that removes part of a lamina of the vertebral arch in order to decompress the corresponding spinal cord and/or spinal nerve root.
Complete removal of lamina is called laminectomy.
Laminotomy is also often accompanied by facetectomy.
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A nerve root is the initial segment of a nerve leaving the central nervous system. It can be of two types
Cranial nerve root
The beginning of one of the twelve pairs leaving the central nervous system from the brain stem or the highest levels of the spinal cord.
Spinal nerve root
The beginning of one of the thirty-one pairs leaving the central nervous system from the spinal cord. Each spinal nerve root consists of the union of a sensory dorsal root and a motor ventral root.
Both of these come out of the spinal cord as the ventral and dorsal roots and merge to form the spinal nerve. The spinal nerve emerges from the spinal column through an opening between adjacent vertebrae except for the first spinal nerve, which emerges between the occipital bone and the atlas or first vertebra.
Outside the vertebral column, the nerve divides into branches or rami. The dorsal ramus contains nerves that serve the dorsal portions of the trunk carrying visceral motor, somatic motor, and sensory branches.
The ventral ramus contains nerves that serve the remaining ventral parts of the trunk and the upper and lower limbs.
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The term radiculopathy refers to describe pain, and other symptoms like numbness, tingling, and weakness in your arms or legs caused by a irritation or compression of nerve roots.
This term comes from a combination of the Latin word “radix,” which means the roots of a tree, and “pathos,” which means a disease.
This condition is often caused by direct pressure from a herniated disc or degenerative changes in the lumbar spine that cause irritation and inflammation of the nerve roots.
Pain and numbness is felt in the area of skin supplied the by sensory fibers of the nerve root. In addition the muscles supplied can show weakness.
Radiculopathy pertaining to lower limb is commonly referred to as sciatica.
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Massage has been used for centuries as a form of stimulation technique aimed at muscle relaxation and improvement in local blood flow. This indirectly gives pain relief. Massage is a part of manipulation therapy which consists of
The term ‘massage’ has been replaced by “soft tissue technique” terminology in view of bad publicity given to massage in late 70s. This therapy involves stroking, kneading picking up, skin rolling etc., of soft tissues (muscles with their fascial sheaths, ligaments, tendons and skin). [Read more...]
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Plasmapheresis is the removal, treatment, and return of blood plasma from blood circulation. The method can also be used to collect plasma for further manufacturing into a variety of medications. It is also known as therapeutic plasma exchange.
Usually plasmapheresis is used to remove antibodies from the bloodstream in diseases like Guillain-Barré syndrome, or to control severity in diseases like myasthenia gravis.
The basic procedure consists of removal of blood, separation of blood cells from plasma, and return of these blood cells to the body’s circulation, diluted with fresh plasma or a substitute. During the course of a single session, two to three liters of plasma is removed and replaced. [Read more...]
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Pain management program aims at providing pain relief and restoration of normal function of part of body/individual. Pain relief is provided by either pharmacological methods or interventions.
Physiotherapy as the word itself indicates is a therapy wherein pain relief and mobilization is provided by physical means like heat and cold, traction, manipulation and electrical stimulation. This therapy is an useful adjunct to conventional methods to provide pain relief and restoration of normal function. [Read more...]
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Severe combined immunodeficiency syndromes (SCID) are group of rare congenital genetic diseases that result in combined T lymphocyte and B lymphocyte deficencies.
These syndromes are cause by defective hematopoietic progenitor cells which are the precursors of both B- and T-cells. This results in a severe reduction in developing thymocytes in the thymus and consequently thymic atrophy. A number of genetic defects can cause SCID.
Few examples are IL-7 receptor deficiency, common gamma chain deficiency, and Recombination activating gene deficiency.
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DiGeorge Syndrome is a genetic disorder caused by the deletion of a small section of chromosome 22. This results in a midline congenital defect including thymic aplasia, or congenital deficiency of a thymus.
Patients may present with a profound immunodeficiency disease, due to the lack of T cells. No other immune cell lineages are affected by the congenital absence of the thymus.
DiGeorge Syndrome is the most common congenital cause of thymic aplasia in humans.
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Myasthenia gravis most commonly affects adults and elderly, but it has been known to occur at any age.Presentation and causes of myasthenia like picture in children differ from adults.
Three types of myasthenic symptoms in children can be distinguished.
Neonatal Myasthenia Gravis
It occurs in 12% of the pregnancies with a mother with myasthenia gravis. In such cases the mother passes the antibodies to the infant through the placenta causing neonatal myasthenia gravis.
The symptoms will start in the first two days and disappear within a few weeks after birth.
Congenital Myasthenic Syndrome
Children of a healthy mother can, very rarely, develop myasthenic symptoms beginning at birth. This is called congenital myasthenic syndrome. It is not caused by an autoimmune process, but due to synaptic malformation, which in turn is caused by genetic mutations.
Thus, CMS is a hereditary disease. More than 11 different mutations have been identified and the inheritance pattern is typically autosomal recessive.
The types of CMS are classified into three categories: presynaptic, postsynaptic, and synaptic.
Presynaptic symptoms include brief stops in breathing, weakness of the eye, mouth, and throat muscles. These symptoms often result in double vision and difficulty chewing and swallowing.
Postsynaptic symptoms in infants include severe muscle weakness, feeding and respiratory problems, and delays in the ability to sit, crawl, and walk. Onset symptoms for all ages may include droopy eyelids.
A particular form of postsynaptic CMS (slow-channel CMS) includes severe weakness beginning in infancy or childhood that progresses and leads to loss of mobility and respiratory problems in adolescence or later life.
Synaptic symptoms include early childhood feeding and respiratory problems, reduced mobility, curvature of the spine, and weakness, which causes a delay in motor milestones..
Juvenile Myasthenia Gravis
It is myasthenia occurring in childhood but after the peripartum period.
[Text adapted from Wikipedia]
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